Organization
DENTAL GROUP OF MILLVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DARLENE L MANDER (OFFICE MANAGER)
(856) 825-9000
Entity
Organization
Contact information
Practice address
1018 N HIGH ST, MILLVILLE, NJ 08332-2527
(856) 825-9000
(856) 327-0767
Mailing address
1018 N HIGH ST, MILLVILLE, NJ 08332-2527
(856) 825-9000
(856) 327-0767
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18903
NJ
1223G0001X
General Practice Dentistry
19011
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1315046
UNITED CONCORDIA
NJ
01
—
335724
UNITED CONCORDIA
NJ
01
—
60008334
HORIZON NJ HEALTH
NJ
01
—
60008837
HORIZON NJ HEALTH
NJ
Enumeration date
07/26/2006
Last updated
08/22/2020
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